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Florida Doctors Preparing for More Cases of Children’s Illness

With the coronavirus still occupying most of their time and attention, doctors in the Sunshine State are dealing with another challenge – a COVID-19-related illness that attacks children and teens.

The disease, in which several body parts such as the heart, lungs, kidneys, brain, gastrointestinal tract, skin or eyes can become inflamed, has infected children and young adults under the age of 21. New York City has reported that 147 children have the condition.

Known as MIS-C, the illness has made its way to Florida with seven confirmed cases, and medical professionals expect to see more.

The condition, although rare, often appears quickly, requires hospitalization, and could become life-threatening if it affects the heart or kidneys.

Officials at six of Florida children’s hospitals say they have admitted and are monitoring children with suspected MIS-C cases.

“Only a small number of children experience MIS-C, but it can be serious and require a lot of support system,” explains Dr. Balagangadhar Totapally, chief of the division of critical care medicine at Nicklaus Children’s Hospital in Miami.

The most common symptoms are persistent fever and abdominal pain and sometimes a rash or pink eye. Previous exposure to COVID-19 appears to be the main risk for becoming infected with the new illness.

Most young people with MIS-C have antibodies against the coronavirus, instead of actually having been infected.

Doctors believe that factor suggests that the syndrome could be the result of a delayed immune response that appears about four weeks after being exposed to the coronavirus.

“MIS-C presents a few weeks after the peak of infection in a community, so that’s right about now,” Totapally adds.

Nicklaus Children’s Hospital is creating a specialized unit for the treatment of children with MIS-C. It will include a four-room pod as part of the hospital’s 40-bed Pediatric Intensive Care Unit.

Totapally’s hospital reported its first case about 10 days ago. He believes Florida may have more cases of the children’s illness than what the state numbers reflect. Although the Centers for Disease Control and Prevention last week created guidance to diagnose MIS-C, “borderline cases may not show up in the numbers,” Totapally says.

At least 12 children in South Florida are being monitored for the illness.

In young children, symptoms of the MIS-C usually resemble those of Kawasaki disease, which is a rare and milder inflammatory illness. However, teens and young adults seem to have a more inflammatory response to MIS-C. Researchers now believe that some children who were originally diagnosed with Kawasaki disease in the U.S. between January and May of this year may actually have had MIS-C instead.

At Joe DiMaggio Children’s Hospital in Hollywood, a section within the COVID-19 unit has been created for children who are thought to have MIS-C. “There is an area now where we do have children undergoing testing to rule out as to whether they have MIS-C. If they all came in presenting the same way, life would be easier for everyone involved,” says Dr. Laura D’Addese, a pediatric cardiologist.

She adds, “The biggest concern we have right now, especially in kids, is largely stemming from inflammation around the heart,” D’Addese said. In South Florida, children’s hospitals are sharing research and experiences.

According to Dr. Paul Robinson, president of the American Academy of Pediatrics Florida Chapter, the state’s pediatricians are on alert. “About 99 percent of the time the children have fevers and they look sick. It should be easy for a doctor,” he says. “If they have seen Kawasaki, they should be comfortable finding this and telling the patient to go to the hospital.

Although there is no cure for MIS-C at this time, local doctors say their patients respond to treatment fairly quickly. Dr. Totapally, at Nicklaus in Miami, says children improve “usually within days.”

As of this week, more than 20 states around the country have reported cases of MIS-C. At least four children, including three in New York and a 15-year-old girl in Maryland, have died of apparent MIS-C in recent weeks.

UPDATED: Local Children Diagnosed with Illness Possibly Linked to COVID-19